Emergency Child Care-Charger Kids Club
This registration form is for the use of Emergency Child Care for Health/Emergency personnel children, District Staff children, Grades Kindergarten-6th.
Phone: 320-286-4100 x1356
School they attend
Childs Allergies (if none, put NA)
Childs Diet Restrictions
Medications to be given while at CKC
Does your child have any of the following?
Does your child have an IEP/504 Plan?
If yes to the previous question, what are the needs of the IEP/504 plan?
Is your child currently receiving special services (one-on-one help, or one-to-one Para) through the school district?
If you answered YES to the previous question, please describe:
Do you have another (2nd) child to add?
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